A 30 year old male is brought to the hospital after falling 6 meters. Inspection reveals an obvious flail chest on the right. The patient is tachypnei Breath sounds are present and symmetrical. There is no significant hyperresonance or dullness. Arterial blood gas obtained while the patient receives oxygen by face mask are: PaO2 of 45mmHg (6Kpa), PaCO2 of 28mmHg (3,7 Kpa) and pH of 7.47. The component of injury that most likely responsible for abnormalities in this patient's blood gas is:

Correct Answer: B

Rationale: The correct answer is B: Pulmonary contusion. Rationale: 1. The patient has a flail chest on the right side, indicating chest wall trauma. 2. Tachypnea suggests respiratory distress to compensate for impaired gas exchange. 3. The ABG shows a low PaO2 (hypoxemia), low PaCO2 (respiratory alkalosis), and high pH (alkalosis), consistent with pulmonary contusion causing ventilation-perfusion mismatch and hypoxemia. 4. Hypoventilation (choice A) would typically show high PaCO2 and low pH. 5. Hypovolemia (choice C) would present with different ABG findings, such as low pH and high bicarbonate. 6. A small pneumothorax (choice D) would not cause such significant gas exchange abnormalities. Summary: Pulmonary contusion is the most likely cause as it fits with the clinical presentation and ABG findings, while the other choices do not

Correct Answer: C

Rationale: The correct answer is C: Primary nursing. In primary nursing, the registered nurse takes on the responsibility for the majority of daily care for specific residents. This model promotes continuity of care and allows the nurse to develop a deeper understanding of the residents' needs. Facility nursing (A) refers to care provided by nurses within a healthcare facility without specifying a particular nurse's role. Team nursing (B) involves a team of healthcare providers working together to deliver care, without one nurse taking primary responsibility. Functional nursing (D) assigns specific tasks to different nursing personnel rather than focusing on individualized care by a single nurse.

Correct Answer: C

Rationale: The correct answer is C: Return charts to their proper place after use. This is the best way for a nursing assistant to keep residents' health information confidential because it ensures that sensitive information is stored securely and not left out in the open where unauthorized individuals can access it. By returning charts to their proper place, the nursing assistant is following proper protocol for maintaining confidentiality and upholding the residents' right to privacy. Choice A is incorrect because discussing a resident's information away from the facility does not guarantee confidentiality and can still risk unauthorized disclosure. Choice B is incorrect as bringing family and friends to the facility can compromise residents' privacy and confidentiality. Choice D is incorrect as posting updates about residents on social media violates their right to privacy and confidentiality.

Correct Answer: B

Rationale: The correct answer is B: Chest pain. Chest pain could be a sign of a serious medical condition like a heart attack, which requires immediate attention. Reporting chest pain to the nurse promptly can lead to timely intervention and potentially save a resident's life. Choices A, C, and D are incorrect as they do not pose immediate life-threatening risks and can be addressed at a later time. Family visiting, watching too much TV, and acting lonely are important aspects of resident care but do not require urgent reporting compared to a potentially critical symptom like chest pain.

Correct Answer: A

Rationale: The correct answer is A: Give the resident time to speak. This is important because individuals with functional barriers may need more time to communicate effectively. By allowing the resident time to speak, the nursing assistant shows respect and promotes effective communication. Removing oxygen (B) or inserting a tracheostomy tube (C) before the resident speaks may hinder communication and potentially harm the resident. Insisting that the resident speak (D) disregards their needs and can lead to frustration and ineffective communication.